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The American Heart Association has been urging people for years to take this preventive approach. Specifically, A.H.A. experts recommend that American men limit themselves to 300 nag of cholesterol a day, and women to 225 mg, roughly the amount in a single egg. They insist that fat should make up no more than 30% (rather than its current 40%) of the diet, and no more than one-third of this should be saturated. "The diet is not a radical one," says A.H.A. President Antonio Gotto. The organization urges a somewhat stricter regimen for people who already have elevated cholesterol levels or a family history of heart disease.
Because atherosclerosis develops slowly throughout life, Gotto believes that children should be started on a low-fat and low-cholesterol regimen at about the age of two. Children who begin eating a sensible diet early in life "are much more likely to follow it in the adult years," he maintains. If everyone were to accept this advice, says Gotto, coronary bypass surgery, now the most common major operation in the U.S. (170,000 were performed last year), would become rare by the end of the century. "We could look forward to the time when atherosclerosis is conquered," he says.
Many Americans have already heeded the A.H.A. gospel. Over the past 20 years, the nation's consumption of butter has dropped 30%, egg consumption has declined 14%, and the average intake of animal fat has plummeted 60%. Over the same two decades, deaths from heart disease have declined 30%.
Even so, not everyone agrees with the A.H.A. on dietary reform. The drop in mortality, some scientists point out, is partly due to better treatment for heart disease and to a decline in smoking among middle-aged men. "I have an aversion to this cholesterolphobia," scoffs Purdue Cardiologist Story. "Why treat everybody? We don't give everybody insulin out of fear of diabetes." According to Rockefeller University's Ahrens, who has spent nearly 40 years studying cholesterol metabolism, individuals differ greatly in their response to dietary fat and cholesterol. "To deny everyone red meat could mean taking away the joy of life unnecessarily," he says. "And as an inexpensive source of good nutrition, there is nothing more glorious than the egg."
It comes as no surprise that the food industry agrees. "Most of us can eat one or two eggs a day without problems, provided we don't eat a lot of saturated fats," says Louis Raffel, president of the American Egg Board. M.F. Brink, president of the National Dairy Council, offers an even stauncher defense of milk, cream and cheese. "Without dairy foods," he says, "people could experience deficiencies of calcium, riboflavin and in some cases vitamin D."